Expansion of the Medicaid low-income health care program in Alaska could bring coverage to tens of thousands of Alaskans, but at an eventual cost of millions of dollars to the state government.
Several Republican governors, including Texas’ Rick Perry, have already said they’ll refused to expand their states’ Medicaid programs, despite the federal government picking up most of the cost.
The federal Patient Protection and Affordable Care Act that was challenged in the U.S. Supreme Court requires states to expand their Medicaid eligibility to 133 percent of federal poverty level.
That could cover as many as 38,000 Alaskans, state officials say.
Alaska Gov. Sean Parnell has spoken of resisting the act’s impact in Alaska, and the June U.S. Supreme Court ruling upholding the act may have given him a way to do so.
The one victory for “Obamacare” opponents in the ruling was a finding that it was unconstitutional for the federal government to coerce states into expanding their Medicaid programs by withholding all federal Medicaid funds if they refuse the expansion.
“That gives Alaska an opening now to reject the expansion,” Parnell said just after the ruling.
“With no penalty we need to rethink what we’re going to do with Medicaid and the requirements that have been imposed by the act,” Parnell told reporters.
It would cost about $300 million per year to do the Medicaid expansion in Alaska, with the federal government picking up 100 percent of the cost for the first three years, with the federal help declining to 90 percent in subsequent years.
“Under Obamacare’s provisions that would require $300 million in new funding,” he said.
The requirement that the state pick up 10 percent of the added amount would add $30 million to the state budget, Parnell pointed out.
And it might be more than that.
“What’s to say that will not grow,” he said.
And Parnell said he’s not even sure the fully funded expansion in the first three years is a good deal for Alaska.
“Free is never free,” he said.
Some in Alaska would like to see Parnell accept the Medicaid expansion, and the federal funding, however.
“I hope he’s taking a really good look at it, it could be really fundamentally important to us,” said Karen Perdue, president and CEO of the Alaska State Hospital and Nursing Home Association.
If people who can’t now pay for their health care were able to do so that would help everyone, she said.
“That would help the business community, that would help insurance rates, that would help costs overall,” Perdue said.
“That is a really important thing, we’re just waiting to see what the governor’s analysis is,” she said.
Parnell’s Commissioner of the Department of Health And Social Services, Bill Streur, is now reviewing the Affordable Care Act in light of the Supreme Court ruling and preparing a recommendation to Parnell on how to proceed.
“Do we want to expand access to health care? Yes,” he said.
But Struer said the Medicaid expansion, and the federal requirements that come with it may not be the way to go, he said.
Despite criticizing federal health care reform efforts, Parnell has also spoken positively of the Medicaid program and noted its importance to thousands of Alaskans.
“That is a valuable program for some of our beneficiaries, no question,” he said.
If Parnell were to reject the federal money, however, it wouldn’t be the first time he’s done so. The 26th Alaska Legislature expanded eligibility for the Denali KidCare program for pregnant women and children, an expansion majority funded by the federal government.
Parnell in 2010 vetoed the $1 million annual state appropriation, saying he’d learned that some of the money would be used for abortions, rejecting federal matching Medicaid money of twice that amount.
A state analysis predicted increasing Denali KidCare would have expanded coverage to 218 pregnant women and 1,277 children.
The Department’s Deputy Director for Health Care Policy, Josh Applebee, said Tuesday the department was working on a recommendation for the governor and was currently trying to get a better idea of what the costs would be. He’d didn’t say when a recommendation would be made.
• Contact reporter Pat Forgey at 523-2250 or patrick.forgey@juneauempire.com
Comments (41)
Add commentThis would be great if i
This would be great if i didnt have to pay federal tax.
Parnell's war...
...on the poor continues.
Medicaid (AK) is better than all other health insurance plans
If only my insurance was as good as AK Medicaid. Medicaid pays for many services that private health insurance doesn't including;
24 hour per day in-home care
Chore workers to clean the home
Airfare, taxi vouchers, hotel vouchers, and meal vouchers for out of town medical visits.
An escort to travel with patient for out-of-town medical appointments
Airfare, and per diem for the escort
Care coordinator to manage patient's travel and care
Medical travel and per diem for a second opinion
And the list goes on and on. Those people insured by AK Medicaid have much better benefits than everyone else. I'll certainly be switching to AK Medicaid the day it becomes available.
@GJSmith
MOst people with private can afford the things you listed from out of pocket. People on Medicaid CANNOT!
Parnell needs those millions.....
to give to his oil tycoon buddies. Hey, someone needs another yacht or a summer home in the hamptons....
Medicaid doesn't pay for anything
It's so easy to cite the program or the government paying for things. It's so easy to just take money or other goodies from the government's various programs. For the 50% of the population that pays no income taxes it's doubly easy. The government cannot give anything to anyone without first taking if from someone else.
The liberal view is that the government already owns every cent you make. It's the government's discretion whether you get any to keep for yourself. Parnell cannot GIVE anything to "oil tycoons," Alaska can only decide how much they should take. Wise up people.
Obama wants to GIVE me a tax cut. Pure BS, he wants me to thank him for taking less of my own money, and vote him in four another miserable 4 years. Ain't gonna happen.
I see the gimme gimme
I see the gimme gimme liberals are out in force today.
Idea...
Actually, we should expand Medicaid to include everyone. Disability should be expanded to anyone who has ever broken a bone during their life. Food stamps should be passed out without the hurdle of paperwork. Unemployment should be indefinate without having to find a job. We should be able to begin collecting social security at age 30. Government housing should come complete with marijuana grow stations and free electric for the grow lights. Government housing should also have hot tubs, swimming pools, weight rooms and tennis courts. We should all be allowed to enjoy the government tit.
I even know how we could pay for it!!! We could outsource the work and pay the contractors by printing money!!! Yea, India's citizens could come over and do the work. All we have to do is convince them that our money is worth more than firestarter! Or we could trade them clean water and all-you-can-eat buffets for labor.
Free food, medical, housing, and hot tubs for EVERYONE!!!
you are paying one way or another
Health care is being paid for those who do not pay by those who do pay. That is a simple fact some wish to leave out. Heath care has increased at an average rate of 5.4% since 1948. Some wish to leave that out. So dream on about how stopping Obamacare is going to save anyone anything. For in the grand scheme of things you'll be paying at the providers or through insurance premiums as we will not return to allowing the non-payers to simply die in the streets as they did in jolly old England.
Our Government (we the
Our Government (we the people) need to stop bending over for the mean spirit that is cloaking this country. Stand up to it , push it back people before we end up back in the dark ages.
Health care should be the right of every single person on the planet.
??
Health care should be the right of every single person you say? It is all rainbows and sunshine to think like this... but I do know believe that child rapists and drug dealers deserve "free" health care. That is crap.
My family works hard at life to have what we have and to bust our butts to keep our jobs that provide us with health care. Why should somebody who isn't willing to do the same have those benefits? Handicapped? Of course I'll pay for you! Elderly? Yeah, you too! Orphaned child at the hospital born addicted to meth? Yep, I would be happy to provide it for you too. But why not improve the programs that already are in place for these people, instead of putting the umbrella up over all the wasted lives? Oh that's right... because pleasing these people means more votes! Woohoo!
FAILURE TO COMMUNICATE
I’ve met dozens of Canadians that are entirely satisfied with their medical care and their system. In fact, only one I've met had a complaint and that was about a particular doctor. Catastrophic illnesses neither costs any family all their earthly belongings forcing bankruptcies nor causes their elderly to divorce to protect assets when one or the other partner approaches the end of life.
America is spending millions to protect us from terrorists making a few people very rich in the process. Perhaps we need to take care of our citizens’ health care first. No doubt the terrorists have and can affect large numbers of our population but health care effects everyone.
Perhaps Obamacare is not what it could be. However, it is a start. We need to quit the party rhetoric for the benefit of all our citizens. Quality health care costs. We already have the most expensive military in the world; its time we turned our focus homeward.
Governor Parnell, stop trying to dump Obamacare and start working to improve our health care. I think the Canadians are onto something.
seniorfrog52@gmail.com
You've met so many canadians that like their health care system. How many canadians have you ever met that enjoy their tax rate? Over 30% income tax if unmarried, sales and sin taxes that destroy a person's personal bank account.
If you like Canada's health care system and tax rates, you should move there. If you want to live in a republic with a Constitution you should stay here. It's up to you. Unfortunately, the Constitution does not allow for you to bring Canada here.
... --- ...
... --- ...
If we are lucky...
Plan A. If we are lucky...lightening will strike each of us individually sometime during our life, before we contract any diseases or are involved in an accident, clearing the way for the next generation and avoiding any need for medical care.
What do you think your odds of that happening are?
Of the number of Plan Bs that might see you or any of us in the US off the planet, many of those plans will see most of us in health care situations before we go, likely with more than one illness and at unbelievable, even unimaginable costs.
So it is not just the members of society with the weakest health, the physically challenged or elderly that might need our protection. Every day life has risks.
Don’t want to pay taxes that will protect a system that even you may need some day? Well maybe you can spend some of that money you save on a lightening rod to hold on to and improve your odds with Plan A.
Canada
The nonpartisan Fraser Institute reported that 46,159 Canadians sought medical treatment outside of Canada in 2011, as wait times increased 104 percent — more than double — compared with statistics from 1993.
Thumbs up or thumbs down, doesn't matter. Facts are facts. Canada does not have the nirvana of health care liberals would like to believe.
BillB, you sure seem to have
BillB, you sure seem to have a bad case of the class warfares. So just because I have a job with insurance you think I can afford all the stuff listed? Most of America is one paycheck, maybe two from the poor house. If you suddenly lost your job and were without income, how long could you last? 90% of America would be in deep fertilizer. So how did you come by your "facts"? Oh, thats right, you just hate anyone luckier or who worked harder than you.
Rights and Liberty
The United States is founded on liberty and the rights of individuals and their freedoms to attain both. Both rights and liberty provide for fundamental opportunity. It is the responsibility of the individuals that make up this great country to grasp opportunity and reap their own benefit. Of course there will be those that need help from their neighbors, but since when does it become the responsibility of the entire nation to ensure everyone gets the benefits, whether they value those benefits, work for those benefits, or both. "If you give a man a fish you feed him for a day. If you teach a man to fish you feed him for a lifetime."
Accept this for the sake of Alaskans who need this!
We all know what is best for the people who really need this!
Do a good thing...accept its heart and soul not money and political thing. Do it out of your own good conscious deed!
Just remeber everyone we are talking about Alaska only here!
Canada As of 2011, it has a
Canada
As of 2011, it has a population of approximately 33.4 million. Canada's economy is one of the world's largest and is reliant upon its natural resources and trade, particularly with the United States with which it also has a long and complex relationship. Per capita income is the world's ninth highest. (Wiki)
Care to guess where the United States ranks? See:
http://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita
akjim
You say “46,159 Canadians sought medical treatment outside of Canada in 2011”.
46,159 Canadians equals o.138 out of 100 or 1.3 out of 1000 people.
46,159 out of 33,400,000 people.
Akjim, thanks for making my point.
I think Canada just might be a role model for US health care.
To the 30YearResident . . . - - - . . .Rights and Liberty
RE: rights and Liberty
How liberated would you feel if you knew your parents, brothers and sisters, children and every one of your friends had the right to medical treatment?
Senior frog
Thank you for making my point, too. Trying to give the Canadian healthcare, particularly when they are having their own problems with access, to a country with 313 million people with essentially the same total income is ludicrous.
Senior Frog: My whole family
Senior Frog:
My whole family has Health Insurance and they all work and pay for it: It feels great
How great would you feel if your whole family lived in a country free of oppressive government and taxes?
How good would it feel if your children had a future because their parents hadn’t left them trillions in debt and with no job base?
The government is the only entity that can legally take your money and freedom...well.. and now with Obamacare the insurance companies.
Why would anyone want more government?
Sorry for the cut and
Atleast in American (for now) I can quit my insurance if they suck…in Canada you get what they give you and thats it....I would rather be free.
Sorry for the cut and paste.
http://getbetterhealth.com/tag/atlantic-institute-for-market-studies
"Canadian Medicare operates in an unregulated, tax-financed, pay-as-you-go model. Our provincial governments are our monopoly provider. They not only pay for necessary care, but they also govern, administer, and evaluate the services that they themselves provide. They define what we call “medically necessary services” and pay for 99% of all physician services. They also forbid the use of private insurance for medically necessary services. They set the budgets for nominally private healthcare institutions. They appoint the majority of their board members and have explicit power to override management decisions.
Under these circumstances, no hospital or hospital administrator can be expected to take any responsibility or initiative because decisions will always be second-guessed by those in political power.
Before the advent of competition in our telephone industry, dissatisfied customers faced the massive indifference of a bureaucracy that took their business for granted, despite some theoretically powerful regulatory agencies. Administrators of the Canadian healthcare system likewise suffer no direct consequences for poor customer service. They aren’t even answerable to a regulatory agency. Accountability is a vague political concept which cannot be enforced in any meaningful way. Like all monopolists, Canada’s healthcare authorities abuse their positions of power."
Insurance...
Insurance is legal protection money. Government regulates it, as is the responsibility of government. To regulate as per the Commerce Clause. Now for government to mandate and regulate legal protection money, that is just criminal. Not surprising these days though.
Not surprising as self-proclaimed constitutionalists and conservatives are telling us we have to vote for Mitt Romney on the conservative ticket. The only conservative in that party is Ron Paul. People say that Ron Paul should run on the Libertarian ticket, well Mitt Romney should run on the democratic ticket.
What bothers me more? People who support Obama and a socialized society or people who claim to be conservatives, do no research, support Romney unquestioned and follow a pathetic mainstream media without watching the youtube videos out there or reading legislation. I'd say the latter. Liberals do not claim one thing and say another. I strongly disagree with them as you've seen me and Persnickety going back and forth. But I know where he stands and he believes what he believes. At least he has a backbone. On the other hand, Romney supporters are supporting a fraudulant RNC/GOP, the corruption is undisputable for those who look into it.
The enemy of the conservitive party isn't the liberal party, it's the liberals in the conservative party. Liberals wearing the conservative uniform are the problem. If they were kicked from the conservative party, things would clean up fast. But we keep on supporting people like Romney and expect things to get better. I thought we might have learned a lesson with Bush. Fool me once shame on you, fool me twice, I'm an idiot!
Frog...
Everyone has access to healthcare - that is the universal right. Can everyone afford the same healthcare - no. If my family member needed assistance with healthcare costs, could I assist without asking the State of Alaska, or the nation to hold the burden, yes. I can help my family because of the opportunity that I seized; and that, coupled with hard work, has allowed me an additional luxury of choice. Not everyone has the same choices, but most everyone has choices. The victims that do not have access to healthcare, they are the ones that should be helped, because they don't have a choice. But then, the government has never been good at ascertaining and managing social need. Why, when it is so much easier to just make it "fair"?
Comparison of federal tax rates: and where it is spent.
Wren
I wondered about your statement that: “Over 30% income tax if unmarried, sales and sin taxes that destroy a person's personal bank account.”
So I looked to see how the federal tax rates between the US and Canada compare
(individual provincial and state taxes not included)
Canadian Federal tax rates for 2012
• 15% on the first $42,707 of taxable income, +
• 22% on the next $42,707 of taxable income (on the portion of taxable income over $42,707 up to $85,414), +
• 26% on the next $46,992 of taxable income (on the portion of taxable income over $85,414 up to $132,406), +
• 29% of taxable income over $132,406.
(Wiki)
United States Federal tax brackets:
Tax Year: 2012
Filing Status: Single
If your taxable income is between...
$0 and $8700 your tax bracket is: 10%
$8700 and $35,35 15%
$35,350 and $85,650 25%
$85,650 and $178,650 28%
$178,650 and $388,650 33%
(wiki)
Then
I looked to see how our military budgets compare:
Canada (population 33.4 million people)
Has a $20 Billion Dollars Military Budget
Or about $600 per person
The United States (population 314 million people)
Has about a 700 Billion Dollars Military Budget
or about $2230 per person
Not too differant in the taxing, but...
Kinda depends on how you want your money spent.
noroadfugitive
My original comment was that in talking to Canadians I did not learn of either a lack of access or meet any unsatisfied or angry people. They love their medical system and do not want to toss it out.
I think your statement,
“Like all monopolists, Canada’s healthcare authorities abuse their positions of power." Is just hot air and a rumor (started by you); so much rhetoric. I’d like to see you back it up.
Can I back up what I’ve said? Don’t talk to me; go talk to some Canadians about their health care system. They love it.
SeniorFrog: How do you want
SeniorFrog:
How do you want your money spent?
The entire Canadian Military has about 100,000 people. About twice the size of our Coast Guard.
They have no nuclear capabilities or air craft carriers.
It very easy and cheap for them (along with most of Europe) to live under the US military umbrella.
Did you see the quotes in my
SenorFrog,
Did you see the quotes in my post?
Here is the author-Dr. Brian Crowley is the Founder and President of the Atlantic Institute for Market Studies in Halifax, Nova Scotia
Please post the names and contact information for the Canadians you know and also how it is they speak for all Canadians.